OBJECTIVE: To observe the changes of heart rate variability (HRV), adrenomedullin (ADM) and B-type natriuretic peptide (BNP) before and after transcatheter closure in children with patent ductus arteriosus. METHODS: HRV spectral values (TF, VLF, LF, HF, LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus (Group PDA, n = 55) before and 3(rd) day, 3(rd) month after transcatheter closure therapy, and in 60 normal children (Group C). RESULTS: (1) Compared with Group C, the HRV spectral values (TF, VLF, HF) were significantly lower (all P < 0.01), LF/HF and the concentrations of plasma ADM, BNP were significantly higher in patients with PDA before transcatheter closure (all P < 0.01). (2) Compared with the values before transcatheter closure values, plasma ADM were significantly reduced at 3(rd) day and 3(rd) month after transcatheter closure (P < 0.01), the HRV spectral values (TF, VLF, HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3(rd) month after transcatheter closure (P < 0.01 or P < 0.05). CONCLUSIONS: HRV and plasma ADM, BNP improved significantly post transcatheter closure in children with patent ductus arteriosus.